Mesalazine (5-aminosalicylic acid) induced chronic hepatitis
| Autor: | P Deltenre, Claude Degott, Dominique Pessayre, Patrick Marcellin, Alain Berson, M Biour |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Cirrhosis Aminosalicylic acid medicine.medical_treatment Case Report Gastroenterology chemistry.chemical_compound Mesalazine Internal medicine medicine Humans Mesalamine Adverse effect Aged Hepatitis Chemotherapy Crohn's disease business.industry Anti-Inflammatory Agents Non-Steroidal medicine.disease Ulcerative colitis Endocrinology Liver chemistry Chemical and Drug Induced Liver Injury Chronic business |
| Zdroj: | Gut. 44:886-888 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gut.44.6.886 |
| Popis: | BACKGROUNDTreatment of ulcerative colitis or Crohn’s disease with sulphasalazine causes several adverse effects, including hepatitis. Sulphasalazine is cleaved by colonic bacteria into 5-aminosalicylic acid and sulphapyridine. Received wisdom was that 5-aminosalicylic acid was topically active, whereas sulphapyridine was absorbed and caused immunoallergic side effects. Mesalazine, a slow release formulation of 5-aminosalicylic acid, was expected to be a safe alternative. However, several cases of acute hepatitis have been reported.CASE REPORTA 65 year old man had increased liver enzymes, anti-nuclear and anti-smooth muscle autoantibodies and IgG levels, and lesions of chronic hepatitis after 21 months of mesalazine treatment. Although liver dysfunction had been identified eight months earlier, simvastatin rather than mesalazine had been withdrawn, without any improvement. In contrast, liver enzyme and IgG levels became normal and autoantibodies disappeared after discontinuation of mesalazine administration.CONCLUSIONContrary to initial expectations, mesalazine can cause most of the sulphasalazine induced adverse effects, and hepatic side effects may be almost as frequent. When liver dysfunction occurs, mesalazine administration should be discontinued to avoid the development of chronic hepatitis and liver fibrosis. |
| Databáze: | OpenAIRE |
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